5 hcc coder jobs found

The goal is this position is to educate providers on proper use of CPT codes, ICD10 codes,  modifiers and audit activities related to health plan operations, risk adjustment, payer audits and  regulatory requirements. This role ensures accurate medical coding, documentation integrity, and  adherence to federal, state, and payer-specific guidelines. The ideal candidate will possess  advanced CPC coding expertise, strong analytical skills, and extensive experience  supporting compliance initiatives within a managed care or health plan environment. This is a full-time position, on site, 5 days a week. Responsibilities: • Serve as subject matter expert on CPT, HCPCS, ICD10 and modifier coding for physicians  and coders. • Ensure provider documentation and coding practices comply with CMS, Medicare,  Medicaid, commercial payer, and applicable federal and state regulatory requirements.  • Conduct coding compliance audits to identify...

JOB SUMMARY: Management and 24-hour responsibility for the planning, organizing, staffing, coordinating, and controlling of all functions of the Health Information Management Department. Serves as Livingston HealthCare’s designated Privacy Officer and is responsible for establishing, implementing, and overseeing an effective privacy program to ensure the appropriate access, use, disclosure, confidentiality, and security of protected health information and personally identifiable information. This position ensures organizational compliance with HIPAA Privacy requirements, supports HIPAA Security compliance in collaboration with the Security Officer, and promotes privacy practices consistent with state and federal regulations, Livingston HealthCare policies, and the organization’s mission, vision, values, and Code of Conduct. Schedule: 1.0FTE (40 hours) Mon-Fri 8a-5p ESSENTIAL FUNCTIONS, DUTIES, AND RESPONSIBILITIES: Prepares and...

JOB SUMMARY: CDI Specialists will collaborate extensively with physicians, nursing staff, other patient caregivers, and medical records coding staff to improve the quality, specificity, accuracy and completeness of the documentation of care provided and coded. CDI Specialist will review medical records for opportunities for diagnosis clarification and validity as it pertains to DRG assignment, severity of illness, risk of mortality, and case mix data as well as timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. These goals will be accomplished by chart review and query placement when appropriate following AHIMA guidelines and CorroHealth policies and procedures. This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended...

Cardiology and Vascular Billing Specialist Location: Port Richey, FL Position Overview We are seeking a detail-oriented   Cardiology and Vascular Authorization and Billing Specialist   to join our team in Port Richey, FL. This role is responsible for ensuring timely insurance approvals (prior authorizations) for cardiac procedures and vein treatments, while managing accurate billing, coding (ICD-10, CPT), and reimbursement processes. The ideal candidate will prevent denials by verifying benefits, providing clinical documentation to payers, and coordinating with clinical staff for peer-to-peer reviews. Key Responsibilities Prior Authorization Acquisition:   Obtain authorization for appointments, tests, and complex vascular/cardiovascular procedures by reviewing clinical documentation and understanding payor guidelines. Clinical Collaboration:   Partner with physicians to gather medical necessity documentation for insurance reviews. Billing & Coding:...

Director of Operations/Revenue Cycle Manager Millstone Healthcare Full-Time | In Person/Leadership Role | Physical Medicine Practice About Millstone Healthcare Millstone Healthcare is a growing multi-disciplinary physical medicine practice with over $3 million in annual revenue and a team of 35+ employees dedicated to delivering exceptional patient care. We specialize in Federal Workers Compensation, Personal Injury, & Aesthetics.  Our collaborative environment brings together providers and staff focused on improving patient outcomes while creating an efficient, positive experience for every patient we serve. We are seeking an experienced, highly organized, and results-driven  Director of Operations/Revenue Cycle Manager  to oversee the daily operations of our practice and help lead our next phase of growth. Position Summary The Director of Operations/Revenue Cycle Manager will be responsible for the overall administrative and operational...